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Childhood predictors of future psychiatric morbidity in offspring of mothers with psychotic disorder

Results from the Helsinki High-Risk Study

Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki

JAANA M. SUVISAARI, MD, PhD

Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, and Department of Psychiatry, University of Helsinki

JARI K. HAUKKA, PhD and JOUKO K. LÖNNQVIST, MD, PhD

Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland

Correspondence: Dr Laura Niemi, Department of Mental Health and Alcohol Research, KTL, National Public Institute, Mannerheimintie 166, FIN-00300 Helsinki, Finland. Tel: +358 9 4744 8894; e-mail: laura.niemi{at}ktl.fi

Declaration of interest None. Funding detailed in Acknowledgements.

Background The Helsinki High-Risk Study monitors women treated for schizophrenia-spectrum disorders in Helsinki mental hospitals before 1975, their offspring, and controls.

Aims To compare the development of high-risk and control group children, and investigate which factors predicted future psychiatric disorders.

Method We examined information from childhood and school health record cards of 159 high-risk and 99 control group offspring. Logistic regression was used to assess whether developmental abnormalities predicted later mental disorders.

Results Compared with controls, children in the high-risk group had more emotional symptoms before school age, attentional problems and social inhibition at school age, and neurological soft signs throughout. In this group pre-school social adjustment problems (OR=9.7, 95% CI 1.8-51.8) or severe neurological symptoms (Fisher's test, P=0.006) predicted future schizophrenia-spectrum disorder. Social adjustment problems and emotional symptoms during school age predicted future non-psychotic psychiatric disorders.

Conclusions Our study supports the validity of neurological, emotional, social and behavioural markers as vulnerability indicators of psychotic and other mental disorders, particularly among children genetically at high risk of psychosis.

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